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Decreased annual risk of tuberculosis infection in South Korean healthcare workers using interferon-gamma release assay between 1986 and 2005

 Eun Hye Lee  ;  Nak-Hoon Son  ;  Se Hyun Kwak  ;  Ji Soo Choi  ;  Min Chul Kim  ;  Chang Hwan Seol  ;  Sung-Ryeol Kim  ;  Byung Hoon Park  ;  Young Ae Kang 
 BMC INFECTIOUS DISEASES, Vol.21(1) : 1161, 2021-12 
Journal Title
Issue Date
Aged ; Cross-Sectional Studies ; Female ; Health Personnel ; Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis* / diagnosis ; Latent Tuberculosis* / epidemiology ; Male ; Republic of Korea / epidemiology ; Retrospective Studies ; Tuberculin Test ; Tuberculosis* / diagnosis ; Tuberculosis* / epidemiology
Annual risk of infection ; Health care workers ; Interferon-gamma release assays ; Latent tuberculosis infection ; Prevalence
Background: Tuberculosis (TB) has been a major public health problem in South Korea. Although TB notification rate in Korea is gradually decreasing, still highest among the member countries of the Organization for Economic Cooperation and Development. To effectively control TB, understanding the TB epidemiology such as prevalence of latent tuberculosis infection (LTBI) and annual risk of TB infection (ARI) are important. This study aimed to identify the prevalence of LTBI and ARI among South Korean health care workers (HCWs) based on their interferon-gamma release assays (IGRA).

Methods: This was single center, cross-sectional retrospective study in a tertiary hospital in South Korea. We performed IGRA in HCWs between May 2017 and March 2018. We estimated ARI based on IGRA results. Logistic regression model was used to identify factors affecting IGRA positivity.

Results: A total of 3233 HCWs were analyzed. Median age of participants was 38.0 and female was predominant (72.6%). Overall positive rate of IGRA was 24.1% and IGRA positive rates age-group wise were 6.6%, 14.4%, 34.3%, and around 50% in the age groups 20s, 30s, 40s, and 50s and 60s, respectively. The ARIs was 0.26-1.35% between 1986 and 2005; rate of TB infection has gradually decreased in the last two decades. Multivariable analysis indicated that older age, healed TB lesion in x-ray, and male gender were risk factors for IGRA positivity, whereas working in high-risk TB departments was not.

Conclusions: Results showed that ARI in South Korean HCWs gradually decreased over two decades, although LTBI remained prevalent. Our results suggest that the LTBI test result of HCWs might be greatly affected by age, rather than occupational exposure, in intermediate TB burden countries. Thus, careful interpretation considering the age structure is required.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo
Kwak, Se Hyun(곽세현)
Kim, Min Chul(김민철)
Kim, Sung Ryeol(김성렬) ORCID logo
Park, Byung Hoon(박병훈)
Seol, Chang Hwan(설창환)
Son, Nak Hoon(손낙훈) ORCID logo
Lee, Eun Hye(이은혜) ORCID logo
Choi, Ji Soo(최지수) ORCID logo
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